Key result
Early attempts at mitral commissurotomy yielded poor results with only 2 of 10 patients surviving, but recent techniques making incisions at the commissures have made surgical relief successful.
This historical review highlights the evolution and early challenges of surgical treatment for mitral stenosis, emphasizing the breakthrough of commissurotomy.
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Emphasizes technique refinement's role in mitral stenosis surgery; leaves open optimal integration into contemporary percutaneous strategies.
Although Samways1suggested over 50 years ago that mitral stenosis should be surgically correctible since it is a mechanical obstruction, 25 years elapsed before the first clinical attempt at mitral valvotomy was reported by Cutler and Levine.2Soon thereafter, mitral commissurotomies were attempted by Allen and Graham,3Pribram,4and Souttar.5Of 10 patients operated on by these surgeons, only 2 survived, and only one of these 2 was improved by the operation.5Such disheartening results discouraged further clinical trials until the recent constructive efforts of pioneers like Smith,6Bailey,7Harken and associates,8and Baker, Brock, and Campbell,9who made successful surgical relief of mitral stenosis a reality. Their success may be attributed to the fact that, in performing valvotomies by making the incision at the point of fusion of the leaflets (commissures), instead of inserting the valvotome into the heart
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Denton A. Cooley (1954) conducted a review in Mitral and aortic stenoses. Mitral valvotomy and commissurotomy was evaluated. Early attempts at mitral commissurotomy yielded poor results with only 2 of 10 patients surviving, but recent techniques making incisions at the commissures have made surgical relief successful.
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